Psychopharmacology

, Volume 222, Issue 1, pp 71–80 | Cite as

Sex differences in stimulus expectancy and pharmacologic effects of a moderate dose of alcohol on smoking lapse risk in a laboratory analogue study

  • Christopher W. Kahler
  • Jane Metrik
  • Nichea S. Spillane
  • Adam M. Leventhal
  • Sherry A. McKee
  • Jennifer W. Tidey
  • John E. McGeary
  • Valerie S. Knopik
  • Damaris J. Rohsenow
Original Investigation

Abstract

Rationale

Alcohol use is often implicated in initial lapses to smoking during quit smoking attempts. Mechanisms explaining this association are unknown but could include (a) learned associations between drinking and smoking or (b) direct pharmacologic effects of alcohol.

Objectives

In a 2 (told alcohol vs. told placebo) × 2 (0.4 g/kg vs. 0.0 g/kg ethanol) between-subjects balanced placebo design, we examined instruction and beverage condition effects on smokers’ ability to resist initiating smoking and whether these effects differed by sex.

Methods

Participants were 96 heavy alcohol drinkers, smoking 10–30 cigarettes per day. After 15 h of smoking abstinence, participants consumed either an alcoholic or a nonalcoholic beverage and 35 min later completed a smoking lapse task.

Results

Overall, neither instructions nor beverage contents influenced behavior on the smoking lapse task. However, the instruction condition had different effects in men and women. Women, but not men, were more likely to smoke and reported expecting greater satisfaction from smoking when they were told alcohol compared to told placebo. The effects of instruction condition on smoking behavior were not mediated by self-reported expected satisfaction from smoking.

Conclusions

Women may be more likely to choose to smoke after drinking moderate amounts of alcohol because of their expectations rather than the pharmacological effects of the alcohol.

Keywords

Alcohol Smoking relapse Nicotine Balanced placebo design Craving Alcohol administration Pharmacologic effects Expectancy effects 

Notes

Conflicts of interest and source of funding

This study was funded by the National Institute on Alcohol Abuse and Alcoholism, grant R01AA016978 to Dr. Kahler, and by a Senior Research Career Scientist award from the Department of Veterans Affairs to Dr. Rohsenow. The authors have no financial relationship with the study sponsor and no conflicts of interest to disclose.

References

  1. Acheson A, Mahler SV, Chi H, de Wit H (2006) Differential effects of nicotine on alcohol consumption in men and women. Psychopharmacology 186:54–63PubMedCrossRefGoogle Scholar
  2. Anthony JC, Echeagaray-Wagner F (2000) Epidemiologic analysis of alcohol and tobacco use. Alcohol Res Health 24:201–208PubMedGoogle Scholar
  3. Augustson EM, Wanke KL, Rogers S, Bergen AW, Chatterjee N, Synder K, Albanes D, Taylor PR, Caporaso NE (2008) Predictors of sustained smoking cessation: a prospective analysis of chronic smokers from the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study. Am J Public Health 98:549–555PubMedCrossRefGoogle Scholar
  4. Baer JS, Lichtenstein E (1988) Classification and prediction of smoking relapse episodes: an exploration of individual differences. J Consult Clin Psychol 56:104–110PubMedCrossRefGoogle Scholar
  5. Borland R (1990) Slip-ups and relapse in attempts to quit smoking. Addict Behav 15:235–245PubMedCrossRefGoogle Scholar
  6. Burton SM, Tiffany ST (1997) The effect of alcohol consumption on craving to smoke. Addiction 92:15–26PubMedCrossRefGoogle Scholar
  7. Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J (2006) Clustering of risk behaviors with cigarette consumption: a population-based survey. Prev Med 42:348–353PubMedCrossRefGoogle Scholar
  8. Cox LS, Tiffany ST, Christen AG (2001) Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings. Nicotine Tob Res 3:7–16PubMedCrossRefGoogle Scholar
  9. Dawson DA (2000) Drinking as a risk factor for sustained smoking. Drug Alcohol Depend 59:235–249PubMedCrossRefGoogle Scholar
  10. Dollar KM, Homish GG, Kozlowski LT, Leonard KE (2009) Spousal and alcohol-related predictors of smoking cessation: a longitudinal study in a community sample of married couples. Am J Public Health 99:231–233PubMedCrossRefGoogle Scholar
  11. Epstein AM, Sher TG, Young MA, King AC (2007) Tobacco chippers show robust increases in smoking urge after alcohol consumption. Psychopharmacology (Berl) 90:321–329CrossRefGoogle Scholar
  12. Falk DE, Yi HY, Hiller-Sturmhofel S (2006) An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Res Health 29:162–171PubMedGoogle Scholar
  13. First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured Clinical Interview for DSM-IV Axis I Disorders. New York State Psychiatric Institute, New YorkGoogle Scholar
  14. Glautier S, Clements K, White JA, Taylor C, Stolerman IP (1996) Alcohol and the reward value of cigarette smoking. Behav Pharmacol 7:144–154PubMedCrossRefGoogle Scholar
  15. Griffiths RR, Bigelow GE, Liebson I (1976) Facilitation of human tobacco self-administration by ethanol: a behavioral analysis. J Exp Anal Behav 25:279–292PubMedCrossRefGoogle Scholar
  16. Gwaltney CJ, Shiffman S, Sayette MA (2005) Situational correlates of abstinence self-efficacy. J Abnorm Psychol 114:649–660PubMedCrossRefGoogle Scholar
  17. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO (1991) The Fagerstrom test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 86:1119–1127PubMedCrossRefGoogle Scholar
  18. Henningfield JE, Chait LD, Griffiths RR (1983) Cigarette smoking and subjective response in alcoholics: effects of pentobarbital. Clin Pharmacol Ther 33:806–812PubMedCrossRefGoogle Scholar
  19. Henningfield JE, Chait LD, Griffiths RR (1984) Effects of ethanol on cigarette smoking by volunteers without histories of alcoholism. Psychopharmacology (Berl) 82:1–5CrossRefGoogle Scholar
  20. Humfleet G, Munoz R, Sees K, Reus V, Hall S (1999) History of alcohol or drug problems, current use of alcohol or marijuana, and success in quitting smoking. Addict Behav 24:149–154PubMedCrossRefGoogle Scholar
  21. Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD (1997) Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control 6:S57–S62PubMedCrossRefGoogle Scholar
  22. Juliano LM, Brandon TH (2002) Effects of nicotine dose, instructional set, and outcome expectancies on the subjective effects of smoking in the presence of a stressor. J Abnorm Psychol 111:88–97PubMedCrossRefGoogle Scholar
  23. Kahler CW, Strong DR, Papandonatos GD, Colby SM, Clark MA, Boergers J, Niaura R, Abrams DB, Buka SL (2008) Cigarette smoking and the lifetime alcohol involvement continuum. Drug Alcohol Depend 93:111–120PubMedCrossRefGoogle Scholar
  24. Kahler CW, Borland R, Hyland A, McKee SA, Thompson ME, Cummings KM (2009) Alcohol consumption and quitting smoking in the International Tobacco Control (ITC) Four Country Survey. Drug Alcohol Depend 100:214–220PubMedCrossRefGoogle Scholar
  25. Kahler CW, Spillane NS, Metrik J (2010) Alcohol use and initial smoking lapses among heavy drinkers in smoking cessation treatment. Nicotine Tob Res 12:781–785PubMedCrossRefGoogle Scholar
  26. Keane TM, Lisman SA, Kreutzer J (1980) Alcoholic beverages and their placebos: an empirical evaluation of expectancies. Addict Behav 5:313–328PubMedCrossRefGoogle Scholar
  27. King AC, Epstein AM (2005) Alcohol dose-dependent increases in smoking urge in light smokers. Alcohol Clin Exp Res 29:547–552PubMedCrossRefGoogle Scholar
  28. King A, McNamara P, Conrad M, Cao D (2009) Alcohol-induced increases in smoking behavior for nicotinized and denicotinized cigarettes in men and women. Psychopharmacology (Berl) 207:107–117CrossRefGoogle Scholar
  29. Kouri EM, McCarthy EM, Faust AH, Lukas SE (2004) Pretreatment with transdermal nicotine enhances some of ethanol’s acute effects in men. Drug Alcohol Depend 75:55–65PubMedCrossRefGoogle Scholar
  30. Leeman RF, McKee SA, Toll BA, Krishnan-Sarin S, Cooney JL, Makuch RW, O'Malley SS (2008) Risk factors for treatment failure in smokers: relationship to alcohol use and to lifetime history of an alcohol use disorder. Nicotine Tob Res 10:1793–1809PubMedCrossRefGoogle Scholar
  31. Marlatt GA, Rohsenow DJ (1980) Cognitive processes in alcohol use: expectancy and the balanced placebo design. In: Mello NK (ed) Advances in substance abuse: behavioral and biological research. JAI Press, GreenwichGoogle Scholar
  32. Martin CS, Sayette MA (1993) Experimental design in alcohol administration research: limitations and alternatives in the manipulation of dosage-set. J Stud Alcohol 54:750–761PubMedGoogle Scholar
  33. McKee SA (2009) Developing human laboratory models of smoking lapse behavior for medication screening. Addict Biol 14:99–107PubMedCrossRefGoogle Scholar
  34. McKee SA, Krishnan-Sarin S, Shi J, Mase T, O'Malley SS (2006) Modeling the effect of alcohol on smoking lapse behavior. Psychopharmacology (Berl) 189:201–210CrossRefGoogle Scholar
  35. McKee SA, Harrison EL, Shi J (2010) Alcohol expectancy increases positive responses to cigarettes in young, escalating smokers. Psychopharmacology (Berl) 210:355–364CrossRefGoogle Scholar
  36. McKee SA, Sinha R, Weinberger AH, Sofuoglu M, Harrison EL, Lavery M, Wanzer J (2011) Stress decreases the ability to resist smoking and potentiates smoking intensity and reward. J Psychopharmacol 25:490–502PubMedCrossRefGoogle Scholar
  37. Mintz J, Boyd G, Rose JE, Charuvastra VC, Jarvik ME (1985) Alcohol increases cigarette smoking: a laboratory demonstration. Addict Behav 10:203–207PubMedCrossRefGoogle Scholar
  38. Murray RP, Istvan JA, Voelker HT, Rigdon MA, Wallace MD (1995) Level of involvement with alcohol and success at smoking cessation in the lung health study. J Stud Alcohol 56:74–82PubMedGoogle Scholar
  39. Nil R, Buzzi R, Battig K (1984) Effects of single doses of alcohol and caffeine on cigarette smoke puffing behavior. Pharmacol Biochem Behav 20:583–590PubMedCrossRefGoogle Scholar
  40. Odum AL, Madden GJ, Bickel WK (2002) Discounting of delayed health gains and losses by current, never- and ex-smokers of cigarettes. Nicotine Tob Res 4:295–303PubMedCrossRefGoogle Scholar
  41. Osler M, Prescott E, Godtfredsen N, Hein HO, Schnohr P (1999) Gender and determinants of smoking cessation: a longitudinal study. Prev Med 29:57–62PubMedCrossRefGoogle Scholar
  42. Perkins KA (2009) Acute responses to nicotine and smoking: implications for prevention and treatment of smoking in lower SES women. Drug Alcohol Depend 104(Suppl 1):S79–S86PubMedCrossRefGoogle Scholar
  43. Perkins KA, Sexton JE, DiMarco A, Grobe JE, Scierka A, Stiller RL (1995) Subjective and cardiovascular responses to nicotine combined with alcohol in male and female smokers. Psychopharmacology (Berl) 119:205–212CrossRefGoogle Scholar
  44. Perkins KA, Doyle T, Ciccocioppo M, Conklin C, Sayette M, Caggiula A (2006) Sex differences in the influence of nicotine dose instructions on the reinforcing and self-reported rewarding effects of smoking. Psychopharmacology (Berl) 184:600–607CrossRefGoogle Scholar
  45. Perkins KA, Karelitz JL, Conklin CA, Sayette MA, Giedgowd GE (2010) Acute negative affect relief from smoking depends on the affect situation and measure but not on nicotine. Biol Psychiatry 67:707–714PubMedCrossRefGoogle Scholar
  46. Rohsenow DJ, Bachorowski JA (1984) Effects of alcohol and expectancies on verbal aggression in men and women. J Abnorm Psychol 93:418–432PubMedCrossRefGoogle Scholar
  47. Rohsenow DJ, Marlatt GA (1981) The balanced placebo design: methodological considerations. Addict Behav 6:107–122PubMedCrossRefGoogle Scholar
  48. Rose JE, Brauer LH, Behm FM, Cramblett M, Calkins K, Lawhon D (2002) Potentiation of nicotine reward by alcohol. Alcohol Clin Exp Res 26:1930–1931PubMedCrossRefGoogle Scholar
  49. Rose JE, Brauer LH, Behm FM, Cramblett M, Calkins K, Lawhon D (2004) Psychopharmacological interactions between nicotine and ethanol. Nicotine Tob Res 6:133–144PubMedCrossRefGoogle Scholar
  50. Sayette MA, Martin CS, Wertz JM, Perrott MA, Peters AR (2005) The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers. Psychol Addict Behav 19:263–270PubMedCrossRefGoogle Scholar
  51. Sherman SE, Wang MM, Nguyen B (1996) Predictors of success in a smoking cessation clinic. J Gen Intern Med 11:702–704PubMedCrossRefGoogle Scholar
  52. Shiffman S (1982) Relapse following smoking cessation: a situational analysis. J Consult Clin Psychol 50:71–86PubMedCrossRefGoogle Scholar
  53. Shiffman S, Gwaltney CJ (2008) Does heightened affect make smoking cues more salient? J Abnorm Psychol 117:618–624PubMedCrossRefGoogle Scholar
  54. Shiffman S, Fischer LA, Paty JA, Gnys M, Hickcox M, Kassel JD (1994) Drinking and smoking: a field study of their association. Ann Behav Med 16:203–209Google Scholar
  55. Shiffman S, Paty JA, Gnys M, Kassel JA, Hickcos M (1996) First lapses to smoking: within-subjects analysis of real-time reports. J Consult Clin Psychol 64:366–379PubMedCrossRefGoogle Scholar
  56. Shiffman S, Gwaltney CJ, Balabanis MH, Liu KS, Paty JA, Kassel JD, Hickcox M, Gnys M (2002) Immediate antecedents of cigarette smoking: an analysis from ecological momentary assessment. J Abnorm Psychol 111:531–545PubMedCrossRefGoogle Scholar
  57. Smith PM, Kraemer HC, Miller NH, Debusk RF, Taylor CB (1999) In-hospital smoking cessation programs: who responds, who doesn’t? J Consult Clin Psychol 67:19–27PubMedCrossRefGoogle Scholar
  58. Sobell LC, Sobell MB (1996) Timeline followback: a calendar method for assessing alcohol and drug use. Addiction Research Foundation, TorontoGoogle Scholar
  59. Sorlie PD, Kannel WB (1990) A description of cigarette smoking cessation and resumption in the Framingham Study. Prev Med 19:335–345PubMedCrossRefGoogle Scholar
  60. Tidey JW, Higgins ST, Bickel WK, Steingard S (1999) Effects of response requirement and the availability of an alternative reinforcer on cigarette smoking by schizophrenics. Psychopharmacology (Berl) 145:52–60CrossRefGoogle Scholar
  61. Wei I (1978) Application of an urn model to the design of sequential controlled clinical trials. J Am Stat Assoc 73:559–563Google Scholar
  62. Westman EC, Levin ED, Rose JD (1992) Smoking while wearing the nicotine patch; is smoking satisfying or harmful. Clin Res 40:871AGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Christopher W. Kahler
    • 1
  • Jane Metrik
    • 1
  • Nichea S. Spillane
    • 1
  • Adam M. Leventhal
    • 2
  • Sherry A. McKee
    • 3
  • Jennifer W. Tidey
    • 1
  • John E. McGeary
    • 4
    • 5
  • Valerie S. Knopik
    • 5
  • Damaris J. Rohsenow
    • 1
    • 4
  1. 1.Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA
  2. 2.Departments of Preventive Medicine and PsychologyUniversity of Southern California Keck School of MedicineLos AngelesUSA
  3. 3.Department of PsychiatryYale University School of MedicineNew HavenUSA
  4. 4.Providence VA Medical CenterProvidenceUSA
  5. 5.Division of Behavior GeneticsRhode Island HospitalProvidenceUSA

Personalised recommendations